Gliederung

Background

Based on the official statistics there is a not fully explained north-south gradient in cardiovascular mortality in Germany. Recent studies indicate that blood pressure and hypertension levels are particularly high in Germany but also highly variable among regions within the country.

Objective

To investigate regional variations in the prevalence and management of hypertension in two communities in the North-East and the South-West of Germany.

Study setting

Two population-based surveys of men and women aged 25 to 74 years using a common standardised protocol: the Study of Health in Pomerania (SHIP; 3744 participants, response 68.8%) and the Kooperative Gesundheitsforschung in der Region Augsburg (KORA; 4224 participants, response 66.8%).

Main outcome measures

Comparison of SHIP and KORA with respect to systolic (SBP) and diastolic (DBP) blood pressure (means with 95% confidence interval [CI]), prevalence of actual hypertension (≥140/90 mmHg or antihypertensive trearment), degree of awareness, treatment and control of hypertension, by age and sex.

Results

The age-standardized means (SBP/DBP) for men in SHIP were 141/87 mmHg and in KORA 133/83 mmHg; the analogue values for women were 128/81 mmHg and 122/78 mmHg. The corresponding prevalences of hypertension in men were 60 % (CI 58-62) in SHIP’s and 41 % (CI 39-43) in KORA’s men; in women the prevalences were 39% (CI 37-40) resp. 29% (CI 27-30). In both regions, men are less aware of their hypertension (42-45%) than women (26-29%) The proportions of awareness, treatment, and control in hypertensives was strikingly similar between the two regions (men p = 0.564; women p = 0.858). If persons were aware of their hypertension, in both regions men were less often under adequate antihypertensive drug treatment compared to women.

Discussion and Conclusions

Thus, our analyses show that prevalence of hypertension is markedly higher in the northern than in the southern part of Germany. Because there are no differences in response rate, measurement procedures, and in the degree of medical care between both regions, it could be assumed, that the risk of hypertension is really higher in the north. Further studies are needed to investigate the causes for this finding.